Individual
GRADY CLEMENCE NESBITT
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
L.AC
Contact information
Practice address
3537 N WILLIAMS AVE, PORTLAND, OR 97227-1437
(720) 273-4254
Mailing address
1007 NE TILLAMOOK ST APT 3, PORTLAND, OR 97212-4062
(720) 273-4254
Taxonomy
Speciality
Code
Description
License number
State
171100000X
Acupuncturist
Primary
185138
OR
Other
Enumeration date
02/11/2019
Last updated
02/11/2019
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